Old Scars

The cesarean section epidemic has been growing in intensity and numbers since the 1970's, in most of the western world, and increasingly in China, India, and South America.

It is a given in most conservative medical circles that the scarred uterus is more fragile during subsequent pregnancies and may rupture during labor. While I do not believe a healthy, though scarred, uterus will rupture without provocation, I have witnessed severe psychological and emotional scars from unnecessary surgery. The World Health Organization suggested in 1985 that a 15% cesarean rate would be optimal. I believe that in countries where mothers and babies and generally healthy (this may exclude the U.S. because of high obesity rates), an optimum emergency c-section rate would be under 5%.

All sorts of shocks and aftershocks have been linked to cesarean sections. Failure to bond, failure to thrive, autism, asthma, breastfeeding problems, PTSD, ADHD, you name it, unnecessary surgery has been implicated.

But what about the effects on a woman as a woman? What about the women who have been having this surgery over the past thirty years? The young ones may mistakenly believe that it is easier on the body for the baby to be extracted surgically; that the low transverse scar just above the pubic bone will heal and remain an almost-invisible thin white line; that urinary and fecal incontinence will be miraculously avoided; that their vaginal muscles will be tight and virginal forever. The middle-aged ones, the menopausal ones, the ladies who have had possibly multiple cesareans, based on the old "once a cesarean, always a cesarean" dictate of the 70's and 80's; these women represent the tip of the cesarean iceberg and their numbers are growing as this rate increases.

Much has been said, especially by men, about the effects of menopause on a woman's emotional state. The old stale jokes abound. But the fact is, that many women start to feel anxious and disoriented about their new status as non-reproductive beings.

I didn't. I have five sons and I am very happy about my contribution to the ongoing human race but I was content to let menstruation go. I do feel ambivalence about growing older - after all, who wants to die? As we age, we do march slowly but surely towards the next big chapter.

So, with the loss of our reproductive capabilities, as we get used to our bodies and ourselves during this phase of life, it is difficult to have to watch the little white bikini line grow into a larger, lumpier line where no matter how many times we march off to the gym, the pleasant softness of middle age insists on bulging unpleasantly underneath and over the top, as if a tight elastic were stretched just above the pubic bone. And it hurts - it still hurts - even after twenty, thirty and forty years.